Provider Demographics
NPI:1174394167
Name:HESHMATI, YASAMAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YASAMAN
Middle Name:
Last Name:HESHMATI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 BEAVERBANK CIR
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3315
Mailing Address - Country:US
Mailing Address - Phone:443-912-2233
Mailing Address - Fax:
Practice Address - Street 1:250 ENGLAR RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2929
Practice Address - Country:US
Practice Address - Phone:410-876-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist